February 10, 2009

Helping Patients Make More Informed Decisions

There is a growing movement among the healthcare community to help patients receive clear, unbiased reports of their conditions and the variety of approaches to therapy.

Since there is no one-size fits-all approach to many disorders, the goal is to equip patients with the right amount of straightforward information so they can make an informed decision on the best treatment.

"No matter how hard I tried to be objective, inevitably my personal biases got involved," breast surgeon Dr. Dale Collins of New Hampshire's Dartmouth-Hitchcock Medical Center (DHMC), which helped pioneer the concept that it calls shared decision-making, told the AP.

In the current climate of health care reform, the concept is being revisited by many states. The state of Washington has also passed a law that encourages the idea.

At DHMC, doctors meet with patients for one-on-one counseling sessions for any medical condition.

Patients are also granted information via the hospital's decision aid library, which provides information on a wide variety of health conditions including back pain, heart disease, breast cancer and cancer screening tests. These decision aids can come in the form of a video, booklet, and many of them can be accessed via the Web.

Additionally, patients can use The Ottawa Personal Decision Guide, which is designed to help them make health-related social decisions.

Getting upfront objective information is rare, Dr. Michael Barry of Massachusetts General Hospital told a meeting of the nonprofit Foundation for Informed Medical Decision Making last week, where health workers gathered to debate how to spread "informed choice."

"You're getting so much information thrown at you at one time, it's hard to assimilate," says Alethea Cassidy, 53, of Erie, Pa., who was diagnosed with early-stage breast cancer in March 2007 and received a similar decision-aid video from Allegheny General Hospital

But Patient choice is only one part of good health care; a separate problem is how often doctors fail to offer proven care, such as medications that improve survival after a heart attack, said the AP.

It remains to be seen whether or not the decision aids actually lead to an improved informed choice, but many medical centers are now following DHMC's example.


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